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Assessment of depression, anxiety and quality of life in Singaporean patients with glaucoma

Poster Details

First Author: N.Lim SINGAPORE

Co Author(s):    C. Fan   M. Yong   E. Wong   L. Yip           

Abstract Details

Purpose:

To determine the prevalence and risk factors for anxiety disorder and depression among glaucoma patients in Singapore, and to assess the relationship between quality of life and depression/anxiety.

Setting:

Tan Tock Seng Hospital, Singapore

Methods:

In this cross-sectional study, glaucoma patients aged 21 and above, with a known diagnosis of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) were recruited. Patients with other types of glaucoma, co-existing ocular or psychiatric disorders were excluded. Ophthalmic examination was carried out on all participants, which included best-corrected visual acuity, intraocular pressure, gonioscopy, standard automated perimetry, and optic disc evaluation. Socio-demographic information and treatment histories were also collected. The Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and Visual Function Questionnaire (VFQ-25) were administered to evaluate for depression, anxiety and impact on quality of life respectively.

Results:

The frequency of depression and anxiety was 30% and 64% respectively. There was no significant difference in the presence of depression/anxiety between patients with POAG and PACG. Risk factors for depression included: female gender (p=0.020), higher logMAR BCVA in the worse eye (p=0.004), higher CDR (p= 0.016), lower MD in the better and worse eye (p=0.022 and p=0001 respectively) and lower mean VFQ25 score (p<0.001). Risk factors for anxiety included: lower MD in the worse eye (p=0.004), and lower mean VFQ25 score (p=0.004). There was no significant association between use of topical beta-blockers/carbonic anhydrase inhibitors with depression/anxiety.

Conclusions:

There is a relatively high prevalence of depression (30%) and anxiety disorders (64%) among glaucoma patients in Singapore. Female glaucoma patients are more likely to suffer from depression. Other risk factors for depression and anxiety disorder include higher CDR, higher logMAR BCVA, and lower MD and a lower mean VFQ25 score. Ophthalmologists could consider use of the VFQ25 as an assessment for impairments in quality of life in a glaucoma patient. If a glaucoma patient is at high risk of depression or anxiety disorder, a multidisciplinary management approach involving ophthalmology and psychiatry may be required.

Financial Disclosure:

NONE

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